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General NPI Number Information
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NPI Number | 1760663447
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Entity Type | Organization
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Legal Business Name | SSM MEDICAL GROUP
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Dates
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Enumeration Date | 11/21/2007
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Last Update Date | 11/21/2007
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Provider Practice Location Address
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Address Line | 6400 CLAYTON RD SUITE 216
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City | SAINT LOUIS
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State | MO
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Zip | 63117-1850
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Country | US
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Telephone | 314-646-7848
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Fax |
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Provider Business Mailing Address
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Address Line | 7980 CLAYTON RD SUITE 202
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City | SAINT LOUIS
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State | MO
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Zip | 63117-1354
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Country | US
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Telephone | 314-951-5330
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | LESA SCHNARR
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Credential |
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Telephone | 314-951-5330
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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